Document Detail

Renal and cardiac function for long-term (10 year) risk stratification after myocardial infarction.
MedLine Citation:
PMID:  19389787     Owner:  NLM     Status:  MEDLINE    
Aims To determine whether combined renal and cardiac function after acute myocardial infarction (MI) predicts 10 year mortality and heart failure (HF). Methods and results Estimated glomerular filtration rate (eGFR), plasma amino terminal pro-brain natriuretic peptide (NT-proBNP), and radionuclide ventriculography were obtained in 1063 patients with MI between 24-96 h of symptom onset. Mortality and HF were documented over follow-up of 9.3 years. Estimated GFR, NT-proBNP, and left ventricular ejection fraction (LVEF) each independently predicted 10 year mortality. Reduced eGFR (below 60 mL/min/1.73 m(2)) combined with increased NT-proBNP (above 1000 pg/mL) was associated with higher mortality rate compared with preserved eGFR together with lower NT-proBNP (60 vs. 14%, P < 0.001). Similar results for mortality were identified for eGFR combined with LVEF (dichotomized about 50%) (58 vs. 17%, P < 0.001). Corresponding analysis combining eGFR and NT-proBNP to predict HF yielded rates of 34 and 7% for high- and low-risk groups, respectively (P < 0.001). Similar risk stratification for HF was observed when combining eGFR with LVEF (35 vs. 7%, P < 0.001). Conclusion Ten year rates of mortality and HF are 5-10 times higher when lower eGFR is present together with increased NT-proBNP or depressed LVEF.
Suetonia C Palmer; Timothy G Yandle; Christopher M Frampton; Richard W Troughton; M Gary Nicholls; A Mark Richards
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-23
Journal Detail:
Title:  European heart journal     Volume:  30     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-15     Completed Date:  2009-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1486-94     Citation Subset:  IM    
Department of Medicine, University of Otago Christchurch, 2 Riccarton Avenue, Christchurch 8140, New Zealand.
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MeSH Terms
Cohort Studies
Glomerular Filtration Rate / physiology
Heart Failure / blood,  mortality,  physiopathology*
Kidney Failure, Chronic / blood,  mortality,  physiopathology*
Middle Aged
Myocardial Infarction / blood,  mortality,  physiopathology*
Natriuretic Peptide, Brain / blood
Peptide Fragments / blood
Risk Assessment
Stroke Volume / physiology
Time Factors
Ventricular Dysfunction, Left / blood,  mortality,  physiopathology*
Reg. No./Substance:
0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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